(A)The following
definitions apply to this rule:
(1)"Assigned
medical support" means the medicaid applicant, recipient, or participant
has assigned the right to collect and retain medical support from an obligor or
medical reimbursement from a third party to the Ohio department of job and
family services (ODJFS).
(2)"Third
party" means any private medical insurer, individual, entity, or public or
private medical program that is or may be liable to pay all or part of the cost
of injury, disease, or disability on behalf of a medicaid applicant, recipient,
or participant.
(B)When the child
support enforcement agency (CSEA) is made aware of an accident or injury
involving the medicaid applicant, recipient, or participant, the CSEA shall
complete the ODM 06613, "Accident/Injury Insurance Information"
(effective or revised effective date as identified in rule 5101:12-1-99 of the
Administrative Code), send it to the Ohio department of medicaid (ODM), and
send a copy to the county department of job and family services (CDJFS).
(C)When assigned
medical support and assigned third party collections are received:
(1)The CSEA is
entitled to have fifteen per cent of the total collection; and
(2)ODJFS is entitled to have eighty-five per cent of the total
collectionThe remainder is distributed to ODM,
subject to the applicable federal medical assistance percentage (FMAP) that is
calculated annually by the federal government.
Effective: 6/1/2021
Five Year Review (FYR) Dates: 1/28/2021 and 06/01/2026
Certification: CERTIFIED ELECTRONICALLY
Date: 04/09/2021
Promulgated Under: 119.03
Statutory Authority: 3125.25
Rule Amplifies: 3125.03, 3125.25
Prior Effective Dates: 01/07/1985, 08/01/1986, 12/01/1987,
12/20/1988, 09/01/1989, 08/01/1990, 06/01/1991, 11/01/1991, 07/15/1992,
04/01/1993, 01/01/1998, 12/20/1998, 07/01/2002, 10/02/2003, 01/01/2007,
05/01/2012, 06/01/2015